Despite the best efforts of the dentist, there are times when a tooth is beyond restoration and has to be extracted. Often, in these circumstances, the patient could suffer from dental injection and pain if the tooth was allowed to remain. The cause of the infection or pain may be gross caries, severe trauma and periodontal disease.
There are also several reasons why a tooth may be extracted electively, and these include the following:
- Prosthetic reasons, when the tooth is mal-aligned and prevents the placement of a denture or bridge
- Severe mal-alignment that can’t be corrected orthodontically
- To create space in a crowded dental arch so that other teeth can be aligned orthodontically
- Partially erupted and impacted teeth that can’t be cleaned adequately by the patient and suffer from repeated localized infection
- Retained deciduous teeth that prevent their adult successors from erupting correctly
In most cases, a tooth can be simply extracted by loosening it in the bony socket and removing it whole, but, in more difficult cases, a surgical procedure may be required.
Simple Extractions
A tooth is extracted by loosening it in its socket, and then pushing it out of the socket using a variety of dental extraction forceps, elevators or luxators. To loosen the tooth, there must be access to the top of the root or roots for the dentist to hold onto with the extraction forceps — the tooth is never held by its crown as this would simply fracture during the procedure.
Surgical Extractions
When a tooth has decayed such that caries extends into the root, it is likely to fracture during a simple extraction attempt. Similarly, a heavily filled tooth is weak to the forces applied during extraction and may also fracture and disintegrate during the procedure.
Some teeth, especially multi-rooted posterior ones, have curved roots that make simple extraction difficult, as attempts to elevate them from the socket is one direction often lock the curved roots in place.
In all of these case, the dentist will resort to some form of surgical technique to extract the tooth involved.